Provider Demographics
NPI:1841670684
Name:SPEECH THERAPY PLUS LLC
Entity type:Organization
Organization Name:SPEECH THERAPY PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERNOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:201-509-8205
Mailing Address - Street 1:391 S MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-1537
Mailing Address - Country:US
Mailing Address - Phone:201-509-8205
Mailing Address - Fax:201-857-5766
Practice Address - Street 1:391 S MAPLE AVE
Practice Address - Street 2:
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-1537
Practice Address - Country:US
Practice Address - Phone:201-509-8205
Practice Address - Fax:201-857-5766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-07
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00747200261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech